| NPI | 1235118092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 16798) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 9901507) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2012-09-28 |