| NPI | 1154310597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-10864) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD26309) |
| 207X00000X Orthopaedic Surgery (Licence: OR 26309) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2016-02-19 |