| NPI | 1871545897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 29478) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036-087377) |
| 207X00000X Orthopaedic Surgery (Licence: WI 28791) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2011-01-12 |