| NPI | 1194791707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 67468) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101102607) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-01-02 |