| NPI | 1831455450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 24897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 51989) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2018-12-19 |