| NPI | 1942410048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 83615) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS15483) |
| 207X00000X Orthopaedic Surgery (Licence: MD H74117) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-08-23 |