| NPI | 1356769673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 53745) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: KY 53745) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-10-25 |