| NPI | 1881743664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT EF4323200BF) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 105636) |
| 207X00000X Orthopaedic Surgery (Licence: MN 54532) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2015-05-28 |