| NPI | 1255576377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 23535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R1910) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2013037725) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 201302054) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2023-06-12 |