| NPI | 1740493493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 10226) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A121481) |
| 207X00000X Orthopaedic Surgery (Licence: TX Q9230) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-07-21 |