| NPI | 1780084715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 38095) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2015021620) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2021-01-25 |