| NPI | 1861683203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 21418) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA pgy.2.tul-osur) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2020-07-20 |