| NPI | 1184688376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 23619) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 023619) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-12-01 |