| NPI | 1053407619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 10375) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 13455) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-03-28 |