| NPI | 1730139890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 7176) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 45935) |
| 207X00000X Orthopaedic Surgery (Licence: UT 6387824-1205) | |
| 207X00000X Orthopaedic Surgery (Licence: IA 37741) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-09-19 |