| NPI | 1477948297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX BP10072762) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101021505) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-06-28 |