| NPI | 1982730206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 56986) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NC 200901063) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-12-29 |