| NPI | 1295042976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 2628) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT012646) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2014-04-21 |