| NPI | 1902895790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL m23434) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL m023424) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2019-04-09 |