| NPI | 1083719793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD20430) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD20430) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-01-21 |