| NPI | 1336160589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 7599) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 51051) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-04-22 |