| NPI | 1174736599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 201001601) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI AB3102516-3183) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2012-01-04 |