| NPI | 1821006289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M9901) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A95193) |
| 207X00000X Orthopaedic Surgery (Licence: NV 11808) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-02-27 |