| NPI | 1831174846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 54150) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 217180) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2016-12-06 |