| NPI | 1184815367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N7707) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP1-0029078) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-01-18 |