| NPI | 1710948815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX F4038) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101232423) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2014-03-28 |