| NPI | 1538334677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101243687) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0067786) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2012-06-21 |