| NPI | 1013000769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS14041) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2006022623) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: MO 2006022623) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-01-10 |