| NPI | 1063483824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E5387) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R8G14) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-09-09 |