| NPI | 1538377585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 7017567-1204) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 005142) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2017-01-25 |