| NPI | 1225184997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 8171A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26041) |
| 207X00000X Orthopaedic Surgery (Licence: SD 9294) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-09-30 |