| NPI | 1184667966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.03443R) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL28900) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-11-01 |