| NPI | 1104086263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-7716) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 26387) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2014-11-05 |