| NPI | 1902120520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 87128) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 56261) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2023-03-16 |