| NPI | 1083785901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 01012201693) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 1902) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-01-09 |