| NPI | 1235484312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 86314) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 3551) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-09-10 |