| NPI | 1316084056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60023058) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD P17178) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-10-02 |