| NPI | 1891877742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 068525) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2012-00860) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2013-08-23 |