| NPI | 1922204239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 8778) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 40898) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2021-07-16 |