| NPI | 1972513083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M9278) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD25792) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2013-04-01 |