| NPI | 1417122391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 7535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 38592) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2010-09-29 |