| NPI | 1821484163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102206634) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 04750) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2021-07-12 |