| NPI | 1861489734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 9600283) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 732) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2007-07-08 |