| NPI | 1346357951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101252921) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 39663) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2017-02-02 |