| NPI | 1801075759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-4869) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 4531) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2011-07-12 |