| NPI | 1992836837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2008-00640) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 230936) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-09-05 |