| NPI | 1609004761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 32018) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD451969) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2023-01-05 |