| NPI | 1497957732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 076920) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 254012) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2018-05-02 |