| NPI | 1700080389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E6967) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P0122) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-12-28 |