| NPI | 1407075328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-11063) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 5294) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-04-21 |