| NPI | 1467400119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 19175) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 36694) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-07-21 |