| NPI | 1225038482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX G6255) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR R3615) |
| 207X00000X Orthopaedic Surgery (Licence: LA R013192L105529) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2013-10-08 |