| NPI | 1730561879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A135376) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 273960) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2019-08-28 |