| NPI | 1912903998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102037163) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2019-02810) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2024-04-25 |