| NPI | 1215193677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS18960) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR DO157319) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2022-08-29 |