| NPI | 1457431082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 20712) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2010-01833) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-02-16 |