| NPI | 1073742573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 074428) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2019-01795) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2021-03-19 |