| NPI | 1720094089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 5001) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 35462) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-02-09 |