| NPI | 1649242678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G67365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 50466) |
| 207X00000X Orthopaedic Surgery (Licence: OK 20554) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2025-05-15 |