| NPI | 1598102253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 80145) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 35714) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2019-09-23 |