| NPI | 1609831809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA md60318075) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP027) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2017-08-31 |