| NPI | 1982701462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.30316) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH RT-1461) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2019-01-10 |