| NPI | 1114238474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 076656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 40050) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2010021765) | |
| 207X00000X Orthopaedic Surgery (Licence: RI 14886) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2018-07-13 |