| NPI | 1225035181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-00314) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DE c20003481) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2015-09-30 |