| NPI | 1699966549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.201229) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 53626-20) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2023-02-15 |