| NPI | 1760407183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101277088) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 3215571205) |
| 207X00000X Orthopaedic Surgery (Licence: NH 16795) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-04-25 |