| NPI | 1700152543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 81552) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 131030) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2023-11-03 |