| NPI | 1003217621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 11854) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA DO-05498) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2020-08-07 |