| NPI | 1497851547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 29298) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 18730) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-05-26 |