| NPI | 1265553655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS020600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 3287) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101015344) | |
| 207X00000X Orthopaedic Surgery (Licence: FL OS12869) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2024-04-04 |