| NPI | 1831553825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 68064) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 55426) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-07-28 |