| NPI | 1285856955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2011014266) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 064483) |
| 207X00000X Orthopaedic Surgery (Licence: GA 001290) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-11-05 |