| NPI | 1710277744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 52287) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101260365) |
| 207X00000X Orthopaedic Surgery (Licence: MD D0081329) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2022-07-26 |