| NPI | 1679776082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2009-00550) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 058948) |
| 207X00000X Orthopaedic Surgery (Licence: FL OS10395) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-06-03 |