| NPI | 1033166962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.205884) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 21127) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2017-04-17 |