| NPI | 1356518146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N9355) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 245506) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2013-04-11 |