| NPI | 1548455504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101243171) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0065438) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2012-03-29 |