| NPI | 1285751859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2011024871) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT186890) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2012-03-29 |