| NPI | 1164408654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 24225NC) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 24225) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2010-03-30 |