| NPI | 1871537266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA MD.021220) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 021220) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-12-07 |