| NPI | 1205929213 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0062198)  | 
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD D0062198)  | 
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2009-07-01 |