| NPI | 1205880689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM A-930-91) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM A-930-91) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-03-28 |