| NPI | 1801068929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC 149984) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0116017285) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2020-12-01 |