| NPI | 1790993160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: IA 39605) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-7615) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2019-09-12 |