| NPI | 1770562001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2013-00519) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101257757) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2021-11-10 |