| NPI | 1144336132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD14566) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00034566) |
| 207X00000X Orthopaedic Surgery (Licence: CA G45853) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-12 |