| NPI | 1477654473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102203415) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OTO11281) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: PA OSO13828) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-12-11 |