| NPI | 1972517563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 1881) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 33854) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-01-28 |