| NPI | 1184629727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2011-0257) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO CDR.0001925) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-08-29 |