| NPI | 1659358091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 27539) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 43125) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2011-06-14 |