| NPI | 1780698159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 21278) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 21278) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-12-27 |