| NPI | 1124292263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 060461) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q4967) |
| Enumeration Date | 2008-04-19 |
| Last Update Date | 2023-12-19 |