| NPI | 1265570469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 200300626) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 120032) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2016-12-19 |