| NPI | 1215034483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 028947) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 00009766) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-01-10 |