| NPI | 1386058089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 306880) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 28888) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2022-04-11 |