| NPI | 1609051697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 42808) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP546) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2018-11-02 |