| NPI | 1649530106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 322734) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX bp10050666) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2021-01-11 |