| NPI | 1871806315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 73593) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT211866) |
| 207X00000X Orthopaedic Surgery (Licence: CA A149777) | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2024-12-11 |