| NPI | 1053490268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 37185) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 29278) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-05-27 |