| NPI | 1487626313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR DO169772) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 147-321) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 3671) | |
| Enumeration Date | 2006-02-04 |
| Last Update Date | 2021-01-26 |