| NPI | 1205098290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 072673) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 237504) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-01-10 |