| NPI | 1982718268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2006017632) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2006017632) |
| 207X00000X Orthopaedic Surgery (Licence: GA 65970) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2021-08-05 |