| NPI | 1316137862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-11774) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID TL-3904) |
| 174400000X Specialist (Licence: ID M11774) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-04-26 |