| NPI | 1578772331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 28515) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 21661) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2022-07-21 |