| NPI | 1467689265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T0379) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.204435) |
| 207X00000X Orthopaedic Surgery (Licence: CT 56732) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 84354) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-04-15 |