| NPI | 1154365575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 31372) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD030154L) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-06-18 |