| NPI | 1831571207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 4607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY C4963) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2026-04-13 |