| NPI | 1376633867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD XXX) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR E-3787) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD XXX) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-10-27 |