| NPI | 1598731796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 41399) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-055175) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01081485A) | |
| 207X00000X Orthopaedic Surgery (Licence: LA 14779R) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-09-28 |