| NPI | 1780609289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 47402) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101243241) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-10-26 |