| NPI | 1518177559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 062612) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 32673) |
| 207X00000X Orthopaedic Surgery (Licence: LA 200792) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-11-01 |