| NPI | 1205829249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX L3007) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 051062) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2008-08-29 |