| NPI | 1023002466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 29432) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 21142) |
| 207X00000X Orthopaedic Surgery (Licence: GA 032102) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2010-04-05 |