| NPI | 1366518623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC MD13578) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D37589) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101042909) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-10-28 |