| NPI | 1104891431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 29937) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 31203) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2009-03-11 |