| NPI | 1922065119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM 200143) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 43662) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-10-05 |