| NPI | 1083871305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 48609) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 241537) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60191176) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2011-07-06 |