| NPI | 1194752246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 19062) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.025028) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2019-03-14 |