| NPI | 1730109430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX D5951) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 17197) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-03-28 |