| NPI | 1376538686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2008-01483) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 44155) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2014-08-11 |