| NPI | 1013203470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2018-02063) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 269962) |
| 208600000X Surgery (Licence: NC 173880) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2020-10-25 |