| NPI | 1003170820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS019800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS16559) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-08-02 |