| NPI | 1073582862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 6782459-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD23859) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2011-06-09 |