| NPI | 1629383997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C146477) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 105068) |
| 207X00000X Orthopaedic Surgery (Licence: AR E-7112) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 53253) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2022-08-15 |