| NPI | 1336594621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 31374) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D91528) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2023-08-29 |