NPI | 1902260193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 55787) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP212) |
Enumeration Date | 2016-04-13 |
Last Update Date | 2023-04-18 |