| NPI | 1639217763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK MEDS6442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R0632) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2023-11-27 |