| NPI | 1528061264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA DO-02193) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 66249) |
| Enumeration Date | 2005-05-26 |
| Last Update Date | 2019-08-22 |