| NPI | 1306125190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS018871) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT014266) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2024-10-04 |