| NPI | 1861615775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101235411) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.202668) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-02-17 |