| NPI | 1790847978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 42715) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 42715) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2012-05-18 |