| NPI | 1063448298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 40138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 30932) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-01-21 |