| NPI | 1992062566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-16032) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.131519) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2022-01-24 |