| NPI | 1851489280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 8558) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME65754) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-04-14 |