| NPI | 1134461965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL me150012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 273838) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2021-07-09 |