| NPI | 1730403494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 006957) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101018746) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2016-09-16 |