| NPI | 1629012919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD3931) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: HI MD3931) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-01-21 |