| NPI | 1912173071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 242069) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 068805) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2018-03-17 |