| NPI | 1881612679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 41080) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL24185) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-08-03 |