| NPI | 1164742631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 39946) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2016-01614) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2023-11-10 |