| NPI | 1306296637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 93041) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT211420) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-08-09 |