| NPI | 1326422171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 87543) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 7557) |
| 207X00000X Orthopaedic Surgery (Licence: KY 53449) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2022-11-22 |