| NPI | 1558325241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA G52440) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 25979) |
| 207X00000X Orthopaedic Surgery (Licence: IA 52440) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2023-11-30 |