| NPI | 1235349820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 7989266-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301088176) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2011-09-22 |