| NPI | 1619065869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 42715) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL 29657) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME 93221) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-03-02 |