| NPI | 1003823170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 1241) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47259) |
| 207X00000X Orthopaedic Surgery (Licence: IA 26304) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2010-01-16 |