| NPI | 1407351968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 57789) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS pending) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-06-22 |