| NPI | 1952746521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2019013302) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0060799) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-08-23 |