| NPI | 1912948910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2007007764) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 47813) |
| 207X00000X Orthopaedic Surgery (Licence: AR E6697) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-03-25 |