| NPI | 1477505634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 34018) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 34018) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-03-02 |