| NPI | 1053342592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0030644) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101036585) |
| 207X00000X Orthopaedic Surgery (Licence: DC MD14460) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-03-22 |