| NPI | 1558636787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0058246) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS019441) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2022-08-25 |