| NPI | 1417960709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M7138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MT 7367) |
| 207X00000X Orthopaedic Surgery (Licence: NM 81-31) | |
| 207X00000X Orthopaedic Surgery (Licence: WA MD00024662) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2014-02-11 |