| NPI | 1518023175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 36757) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 24139) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-07-12 |