| NPI | 1184714941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101048535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00153) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-04-19 |