| NPI | 1538428859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101276301) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2019-01728) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2023-01-06 |