| NPI | 1891135018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 83582) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 6333) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2020-07-07 |