| NPI | 1528290459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR DO174975) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 5828) |
| 207X00000X Orthopaedic Surgery (Licence: DC DO034459) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 34.009952) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 58.003147) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2020-11-11 |