| NPI | 1689646853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63023) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 21582) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2017-12-04 |