| NPI | 1821159849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 44410) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: KY TP797) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-03-01 |