| NPI | 1093733164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 9435) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 2232) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-01-08 |