| NPI | 1992817688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 7829) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 23298) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-07-03 |