| NPI | 1245233063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD28572) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD28572) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-04-30 |