| NPI | 1336358787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D94601) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD456232) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301084327) | |
| 207X00000X Orthopaedic Surgery (Licence: WI 3328-320) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-03-14 |