| NPI | 1346528437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS15465) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT014819) |
| 207X00000X Orthopaedic Surgery (Licence: NV DO2165) | |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2018-09-05 |