| NPI | 1316089535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 25900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2010-01792) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2012-12-27 |