| NPI | 1174816094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D87689) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 061678) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2019-08-15 |