| NPI | 1508972969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2003-00744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2003-00744) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2015-03-19 |