| NPI | 1285635300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 9500296) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 9500296) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2012-03-28 |