| NPI | 1336309129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD205094) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT188356) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2012-04-26 |