| NPI | 1649454000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 01354) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD013546) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2020-01-22 |