| NPI | 1205241965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2020-00750) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 77674) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-07-30 |