| NPI | 1023015773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H6077) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX H6077) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-03-08 |