| NPI | 1215936844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 92222) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-07-8499) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2023-03-06 |