| NPI | 1427077734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 14501A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MT 8555) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-06-28 |