| NPI | 1639263999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2007032032) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A53822) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-03-03 |