| NPI | 1548218654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR-47042) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 227126) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD12364) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-06-16 |