| NPI | 1396704854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 11052) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 20601) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-12-28 |