| NPI | 1114473451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2017022851) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016020038) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2021-07-27 |