| NPI | 1740571066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M15852) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10041565) |
| 207X00000X Orthopaedic Surgery (Licence: NE 27174) | |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61158053) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2022-12-01 |