| NPI | 1225059462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2003-0517) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD067251L) |
| 207X00000X Orthopaedic Surgery (Licence: NM MD067251L) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2023-11-15 |