| NPI | 1881635761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 4725374-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 43447) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-09-07 |