| NPI | 1073603692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 5869285-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: ID M-13257) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-10-16 |