| NPI | 1215987557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 17615) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 17615) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-11-30 |