| NPI | 1164699120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A99534) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 236801) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2011-12-02 |