| NPI | 1326187188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO R5045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R5045) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2011-10-11 |