| NPI | 1225410905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.141607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 27356) |
| 207X00000X Orthopaedic Surgery (Licence: SC LL38278) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2021-09-20 |