| NPI | 1336554823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 91784) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 75167) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2024-07-11 |