| NPI | 1295706539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 220583) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI 12960) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-07-22 |