| NPI | 1326293234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J0944) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 37862) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2008-11-19 |