| NPI | 1073856431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 12260A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 62832) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-10-05 |