| NPI | 1962716761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 9870) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM A-1941-16) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2016-06-07 |