| NPI | 1689758120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 21591) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK 3870) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-10-03 |