| NPI | 1982664488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 52230) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 052230) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2021-07-15 |