| NPI | 1942648944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 84194) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-255376) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-02-26 |