| NPI | 1457355810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 81152) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2017020735) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-01-19 |