| NPI | 1154677508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0061174) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OF015692) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2018-09-05 |