| NPI | 1285052753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 83081) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS019960) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2022-11-03 |