| NPI | 1528038064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX F8414) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX f8414) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2013-09-09 |