| NPI | 1477658060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 5847) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 79945) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-01-16 |