| NPI | 1912132614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 102887) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR0053992) |
| 207X00000X Orthopaedic Surgery (Licence: MA 240783) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2022-07-22 |