| NPI | 1659532331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A137629) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 0054874) |
| 207X00000X Orthopaedic Surgery (Licence: WV 23577) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-01-28 |