| NPI | 1447660451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2019035084) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR DO192433) |
| 207X00000X Orthopaedic Surgery (Licence: NV SL1000) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2024-10-22 |