| NPI | 1306288816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101266708) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT204834) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2022-01-27 |