| NPI | 1669856803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS018522) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT016635) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2022-08-26 |