| NPI | 1659531259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2015-02471) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 23094) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-04-10 |