| NPI | 1801058656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 007948) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 689) |
| 207X00000X Orthopaedic Surgery (Licence: CA 20A16113) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2019-08-09 |