| NPI | 1679520944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 52080611205) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 5208061-1205) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2021-03-02 |