| NPI | 1659690469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 75626) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 075626) |
| 207X00000X Orthopaedic Surgery (Licence: KY R2473) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301107949) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2019-10-23 |