| NPI | 1497705370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 44737) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY TL1091) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-10-06 |