| NPI | 1356443774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 56343) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 038451) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2024-07-01 |