| NPI | 1124235312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 353125-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101245156) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-11-16 |