| NPI | 1710960125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 9400083) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 14535) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2020-07-16 |