| NPI | 1538219712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS020104) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 010205111) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-27 |