| NPI | 1982717138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101251122) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX T4619) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-10-02 |