| NPI | 1508806035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 40384) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 209781) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-06-10 |