| NPI | 1417913567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 31468) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR C-7336) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-06-30 |