| NPI | 1538188404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2013-0590) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 80082) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-11-11 |