| NPI | 1063480861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 061844) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2005032617) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-08-23 |