| NPI | 1720085517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 22089) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 024773) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-07-21 |