| NPI | 1235113234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA 036167) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA 36167) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2014-01-21 |