| NPI | 1851696058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q5505) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL MD.34159) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2017-05-11 |