| NPI | 1154390920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD13165) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 2248235) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2012-11-07 |