| NPI | 1104116227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2017-01006) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0056220) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-02-21 |