| NPI | 1821083650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT 042.0009554) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 0420009554) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2020-09-15 |