| NPI | 1588667034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 15386) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R4B91) |
| Enumeration Date | 2005-05-28 |
| Last Update Date | 2007-10-02 |