| NPI | 1750721098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 04407) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY 04407) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2020-03-13 |