| NPI | 1891892782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX H2755) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H2755) |
| 174400000X Specialist (Licence: FL ME68569) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-04-08 |