| NPI | 1669472635 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD17941) | 
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD17941) | 
| Enumeration Date | 2005-07-29 | 
| Last Update Date | 2008-03-13 |