| NPI | 1811143027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS015012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT012447) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2020-08-31 |