| NPI | 1144266842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD16729) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD08715) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-10-10 |