| NPI | 1356332720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD29397) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 46345) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2015-10-02 |