| NPI | 1609803477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 307337) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 071493) |
| 207X00000X Orthopaedic Surgery (Licence: TN DO0000001192) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-06-11 |