| NPI | 1669488144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 63587) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2008-00859) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2008-00859) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-06-30 |