| NPI | 1194163972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD-46268) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R9821) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: IA MD-46268) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2019-06-21 |