| NPI | 1225394430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 51637) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 61655) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2020-09-03 |