| NPI | 1649298993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301090221) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 178090-1205) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-03-10 |