| NPI | 1356728182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 17500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ R74946) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2021-12-22 |