| NPI | 1861615155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 10105) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2014-01725) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-10-31 |