| NPI | 1083624944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 32382) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301071199) |
| 207X00000X Orthopaedic Surgery (Licence: WA 61248697) | |
| 207X00000X Orthopaedic Surgery (Licence: UT 12645018-1205) | |
| 207X00000X Orthopaedic Surgery (Licence: ME MD25649) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-03-17 |