| NPI | 1578797148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2019043356) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN13437) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2019-12-06 |