| NPI | 1356789390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD-44902) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301103400) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-02-04 |