| NPI | 1922069053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 70690) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS9041) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2019-05-30 |