| NPI | 1225472822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 63149) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 10765982-1205) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-12-28 |