| NPI | 1174569529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 200501321) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 200501321) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-11-19 |