| NPI | 1457343295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 10006) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 010006) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-01-30 |