| NPI | 1609855253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI RL064514) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI RL064514) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2016-07-19 |