| NPI | 1164703922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102204937) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT014089) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2020-05-18 |