| NPI | 1518952613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101025812) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 21213) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2016-03-16 |