| NPI | 1275693749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 070546) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT189277) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-05-29 |