| NPI | 1386754380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 12247) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 31862) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-05-25 |