| NPI | 1497821367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: LA 14289-R) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 29126) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2014-12-17 |