| NPI | 1063611663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0081035) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 16862) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101242011) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2018-05-14 |