| NPI | 1033230776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 250291) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2010-01800) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-07-21 |