| NPI | 1679001747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD61443193) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301112013) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TN 65391) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2023-10-24 |