| NPI | 1902932015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 7376) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 38074) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2021-11-22 |