| NPI | 1588631162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 52227) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS 10434) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-11-17 |