| NPI | 1639144751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101041146) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2016-01367) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-07-27 |