| NPI | 1184819773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 18438) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101252032) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2018-06-12 |