| NPI | 1740256569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 44797) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD9765) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-06-10 |