| NPI | 1073952859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD 0086873) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT203406) |
| 207X00000X Orthopaedic Surgery (Licence: MA 274006) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2022-09-07 |