| NPI | 1184629420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD434872) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0029151) |
| 174400000X Specialist (Licence: DC MD13820) | |
| 174400000X Specialist (Licence: VA 0101035253) | |
| 174400000X Specialist (Licence: NH 14470) | |
| 174400000X Specialist (Licence: DE C1-0008580) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 126602) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2016-12-23 |