| NPI | 1295964583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q3494) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ R71664) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2015-06-16 |