| NPI | 1891898144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N5000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 19474) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2010-06-01 |