| NPI | 1356540496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D76010) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 67523) |
| 207X00000X Orthopaedic Surgery (Licence: SC LL29815) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2018-01-18 |