| NPI | 1659391050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 18740) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 29158) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-12-13 |