| NPI | 1053525238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 63958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 49869) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2010-02042) | |
| 207X00000X Orthopaedic Surgery (Licence: OR 156861) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-03-29 |