| NPI | 1457388589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M3903) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP20019973) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-04-11 |