| NPI | 1548676265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY TP460) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP460) |
| 207X00000X Orthopaedic Surgery (Licence: KY R3661) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-08-03 |