| NPI | 1609876788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 00033658) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 11847) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2014-10-08 |