| NPI | 1093821902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO T2005031078) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX N9576) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-08-11 |