| NPI | 1770516353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 39197) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME39537) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2015-05-19 |