| NPI | 1316046428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT A15261) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 18255) |
| 207X00000X Orthopaedic Surgery (Licence: NY 1148631) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-07-25 |