| NPI | 1477553691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2002-00995) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 00026711) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-08-15 |