| NPI | 1629484340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 85137) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT015677) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-08-03 |