| NPI | 1053328773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 13815) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0058044) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |