| NPI | 1356629885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OT013947) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS017828) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2020-02-24 |