| NPI | 1023491230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 59769) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 7571) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2020-07-20 |