| NPI | 1518934686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2005-01551) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200501551) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2021-08-09 |