| NPI | 1588820864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E7244) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY KY44444) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2011-12-30 |