| NPI | 1598911257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 53653-21) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2007008573) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2021-06-17 |