| NPI | 1003924879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 16044) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD26366) |
| 207X00000X Orthopaedic Surgery (Licence: TN MD009475) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 35902) | |
| 207X00000X Orthopaedic Surgery (Licence: MT 10814) | |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2005-0607) | |
| 207X00000X Orthopaedic Surgery (Licence: OK 24746) | |
| 207X00000X Orthopaedic Surgery (Licence: LA MD05635R) | |
| 207X00000X Orthopaedic Surgery (Licence: CA 52397) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |