| NPI | 1912107764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0062822) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 38028) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2020-01-08 |