| NPI | 1700014909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 70054) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA 60523493) |
| 207X00000X Orthopaedic Surgery (Licence: TX S0607) | |
| 207X00000X Orthopaedic Surgery (Licence: MT 39711) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A115287) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2023-11-14 |