| NPI | 1073510509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD12337) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD12337) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-02-26 |