| NPI | 1427225648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2013-00848) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 201300848) |
| 207X00000X Orthopaedic Surgery (Licence: PA OT012066) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2021-05-07 |