| NPI | 1245218585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 30360) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012020853) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2022-10-21 |