| NPI | 1760500102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO DO48D79) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO DO48D79) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-02-02 |