| NPI | 1730187410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 26497) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 19436) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2012-07-03 |