| NPI | 1003856576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q8291) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2000156464) |
| 207X00000X Orthopaedic Surgery (Licence: MN 107013) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-08-11 |