| NPI | 1790745099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-4593) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 26719) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-02-24 |