| NPI | 1932399698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A98951) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 12254) |
| 207X00000X Orthopaedic Surgery (Licence: UT 5401485-1205) | |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0061770) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2023-01-09 |