| NPI | 1225135700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 230954) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 12933) |
| 207X00000X Orthopaedic Surgery (Licence: NH RT 1069) | |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2008-11-26 |