| NPI | 1629239991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 311241) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101257667) |
| 207X00000X Orthopaedic Surgery (Licence: TN 53975) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2023-03-07 |