| NPI | 1831155811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS007480L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 2164) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 4779) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2011-07-21 |