| NPI | 1184072902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 12699267-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC MMD.39395 LL) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0116034959) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-02-09 |