| NPI | 1598879991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2009-00825) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 25711) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-03-20 |