| NPI | 1194759084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 17296) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 026340) |
| 207X00000X Orthopaedic Surgery (Licence: MA 242326) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-07-13 |