| NPI | 1497989164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 81899) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 47985) |
| 207X00000X Orthopaedic Surgery (Licence: KY R2094) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2020-10-26 |