| NPI | 1992870471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WY 12812A) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AK MEDS7811) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-12-19 |