| NPI | 1063430098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD467328) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD d0056901) |
| 207X00000X Orthopaedic Surgery (Licence: DE C1-0013105) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-07-24 |