| NPI | 1376864942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0057156) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 261980) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2010023564) | |
| 207X00000X Orthopaedic Surgery (Licence: MO 2010019173) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2019-01-03 |