| NPI | 1346349362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD28914) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX E2953) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-04-05 |