| NPI | 1124171541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 36456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 051666) |
| 207X00000X Orthopaedic Surgery (Licence: SC 36546) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2014-03-07 |