| NPI | 1114973815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 10599) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 53532) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-07-14 |