| NPI | 1902011513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0047836) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 54966) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-06-15 |