| NPI | 1467625756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD222569) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 75050) |
| 207X00000X Orthopaedic Surgery (Licence: FL 122314) | |
| 207X00000X Orthopaedic Surgery (Licence: LA MD.202524) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2025-01-21 |