| NPI | 1780868802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.205422) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI 14194) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2015-01-20 |