| NPI | 1962815332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.323773) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL36939) |
| 207X00000X Orthopaedic Surgery (Licence: MS 26572) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2020-08-17 |