| NPI | 1952306037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60112511) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 100891) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2011-06-28 |