| NPI | 1144663949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 55465) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 266312) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2020-12-16 |