| NPI | 1245227701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD12071) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 27743) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2010-01-28 |