| NPI | 1114063435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101054622) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD040109) |
| 207X00000X Orthopaedic Surgery (Licence: MD D9972097) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2018-07-24 |