| NPI | 1023295938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 8740A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD433175) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2020-09-11 |