| NPI | 1659534220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WI 62141-021) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101017818) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-08-27 |