| NPI | 1487720744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR C-8263) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 6799A) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-04-19 |