| NPI | 1356514988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 20638) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA md.200247) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2020-07-20 |