| NPI | 1134448525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS018039) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00059) |
| 207X00000X Orthopaedic Surgery (Licence: GA 071601) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 58.003143) | |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2024-07-03 |