| NPI | 1770786071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 064731) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 24056) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2019-10-31 |