| NPI | 1902919038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 41689) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MT 127305) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-07-23 |