| NPI | 1578017174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2023028364) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL Ps52060) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA 20A17726) | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-09-26 |