| NPI | 1598955825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 48033) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 235012) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2017-02-14 |