| NPI | 1255751921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD198028) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D87636) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-03-09 |