| NPI | 1710084009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: KY 36036) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY 36036) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-04-14 |