| NPI | 1619300266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 95607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 29564) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2023-10-18 |