| NPI | 1851411532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 39175) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 49664) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-02-04 |