| NPI | 1487859609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2012042182) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 046807) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-10-13 |