| NPI | 1316976798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI DOS1239) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS7300) | 
| Enumeration Date | 2006-06-30 | 
| Last Update Date | 2012-08-13 |