| NPI | 1427115625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 36539) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI 12016) |
| 207X00000X Orthopaedic Surgery (Licence: NH LT-2571) | |
| 207X00000X Orthopaedic Surgery (Licence: LA 200708) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2014-04-08 |