| NPI | 1164734422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 12408) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 50375) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2021-02-01 |