| NPI | 1750396479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 54731) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK AK3275) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2019-11-01 |