| NPI | 1033109632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 41236) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM md2005-0490) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2022-10-20 |