| NPI | 1528065919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 17528) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2013) |
| 208600000X Surgery (Licence: NC 201300063) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2022-12-22 |