| NPI | 1497815054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101258650) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 47315) |
| 207X00000X Orthopaedic Surgery (Licence: PA MT185794) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 68667) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-07-07 |