| NPI | 1497016034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 79912) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00691) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2020-07-27 |