| NPI | 1104868280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 4022) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 4022) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-04-24 |