| NPI | 1083981567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 15120) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ZZ G36211) |
| 207X00000X Orthopaedic Surgery (Licence: KY 48377) | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2022-03-28 |