| NPI | 1457394504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 25068) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 9701105) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2014-02-25 |