| NPI | 1477904720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 207X00000X) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016021986) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2022-07-05 |