| NPI | 1386749133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2002-01310) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101055230) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2018-06-05 |