| NPI | 1982915948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 29307) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2010020751) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2016-07-20 |