| NPI | 1245612068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 343401) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS17076) |
| 207X00000X Orthopaedic Surgery (Licence: PA Ot016556) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 312980) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2024-09-25 |