| NPI | 1053306894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 20176) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD192659) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2020-11-03 |