| NPI | 1881896033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS19965) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34008811) |
| 207X00000X Orthopaedic Surgery (Licence: WI 60665-21) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2024-08-23 |