| NPI | 1356637755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD460811) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 16387) |
| 207X00000X Orthopaedic Surgery (Licence: CA A141486) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2018-11-06 |