| NPI | 1609902360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 25783) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 14722) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2011-09-07 |