| NPI | 1891172441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV DO2916) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV SL1069) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NV DO2916) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2021-05-21 |