| NPI | 1932300530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-7495) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T-1950) |
| 207X00000X Orthopaedic Surgery (Licence: TX N7423) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-06-15 |