| NPI | 1649420712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 82553) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.098984) |
| 207X00000X Orthopaedic Surgery (Licence: CA A124374) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2023-10-06 |