| NPI | 1356635619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD464723) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 249151) |
| Enumeration Date | 2011-06-04 |
| Last Update Date | 2018-10-15 |