| NPI | 1508037516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 201532) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA PGY.2-LSUNO) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2011-10-31 |