| NPI | 1457341810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M6126) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M6126) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2013-10-02 |