| NPI | 1215138607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 27982) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-43119) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-03-28 |