| NPI | 1841482098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 141511) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 50897) |
| 207X00000X Orthopaedic Surgery (Licence: KY 46328) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2014-10-21 |