| NPI | 1528326915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 27259) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 275404) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2023-11-16 |