| NPI | 1972779692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2014-01317) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 36553) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2020-02-17 |