| NPI | 1619318060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 278516) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 10822137-1205) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2023-11-15 |