| NPI | 1316143787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 51910) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 45501) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2024-04-09 |