| NPI | 1447544465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 305240) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-247927) |
| 207X00000X Orthopaedic Surgery (Licence: CA A139130) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2019-08-27 |