| NPI | 1386617561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E5667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2003027560) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2012-08-09 |