| NPI | 1023179975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2018-02298) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN9011) |
| 207X00000X Orthopaedic Surgery (Licence: TX N6585) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 060783) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-10-26 |