| NPI | 1487658977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX E8382) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E8382) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2021-12-01 |