| NPI | 1922325190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA Q7846) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL32836) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2020-08-06 |