| NPI | 1285876219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2016-00303) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 257661) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2022-04-25 |