| NPI | 1831502558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-03195) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2019008257) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-09-18 |