| NPI | 1891845947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 10936) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 7534) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2019-03-01 |