| NPI | 1659351096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-01607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102201629) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-09-03 |