| NPI | 1326098385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 30514) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 047281) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-04-24 |