| NPI | 1104961994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME130147) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00042627) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01068319A) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101249094) | |
| 207X00000X Orthopaedic Surgery (Licence: ME MD20796) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2022-08-10 |