| NPI | 1114907508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 17381) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 31646) |
| 207X00000X Orthopaedic Surgery (Licence: MA 265361) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2017-04-26 |