| NPI | 1790090801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS13884) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS017546) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2019-09-16 |