| NPI | 1700856101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 10329R) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX E8504) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2012-11-13 |