| NPI | 1932169844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 35653) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 30618) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2014-07-22 |