| NPI | 1073597100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 13417) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 76336) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2011-07-19 |