| NPI | 1669588802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: AZ 52122) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: AL 30252) |
| 207X00000X Orthopaedic Surgery (Licence: MO T2004017096) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2019-01-10 |