| NPI | 1912218165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0058866) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO pending) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2022-01-06 |