| NPI | 1376938357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2021-00826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0064306) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-09-24 |