| NPI | 1982018503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S6365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 30709) |
| 207X00000X Orthopaedic Surgery (Licence: CA 162013) | |
| 207X00000X Orthopaedic Surgery (Licence: NV 18713) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-02-14 |