| NPI | 1578596763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 33035) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101030631) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-11-09 |