| NPI | 1952622243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101260425) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL32819) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2020-10-22 |