| NPI | 1982697769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS003165L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34002284S) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2007-11-30 |