| NPI | 1730198342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 66154) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SD 9041) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-07-13 |