| NPI | 1568492593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 05535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R1J25) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-05-02 |