| NPI | 1275796765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS11197) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS013921) |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2020-01-27 |