| NPI | 1114986007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 17692) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 28115) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-12-28 |