| NPI | 1285845248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 12770) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101016938) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2014-09-16 |