| NPI | 1376767723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A85526) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 40629) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2012-05-31 |