| NPI | 1609119213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101269633) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2018-00864) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2021-07-15 |