| NPI | 1275504045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD 60037531) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 38725) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2009-01-23 |