| NPI | 1689804270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 3411267) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT013106) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2014-09-02 |