| NPI | 1427179993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 239372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-225495) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-12-30 |