| NPI | 1386737641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS18759) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-105518) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2022-07-05 |