| NPI | 1285073916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 62321) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 6977) |
| Enumeration Date | 2013-06-15 |
| Last Update Date | 2022-03-23 |