| NPI | 1942201538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 21028) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 21028) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2014-02-10 |