| NPI | 1760423586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 43672) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2006002622) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-01-26 |