| NPI | 1154853810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2022-00664) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 64159) |
| 207X00000X Orthopaedic Surgery (Licence: MN 28411) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-05-11 |