| NPI | 1326018391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME86347) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K5484) |
| 207X00000X Orthopaedic Surgery (Licence: GA 054597) | |
| 207X00000X Orthopaedic Surgery (Licence: UT 4940494-1205) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |