| NPI | 1710099676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 8334539-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML20008734) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-07-03 |