| NPI | 1346223880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 22466) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 056541) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WV 22466) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-11-17 |