| NPI | 1912999475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 16336) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 016336) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2020-07-31 |