| NPI | 1356329114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60144423) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47815) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2010-11-15 |