| NPI | 1013968668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 027621) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 027261) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |