| NPI | 1326073537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2018003871) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 290836-1205) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-09-22 |