| NPI | 1407050248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 35229) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-01344) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-03-14 |