| NPI | 1407923758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD-42246) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2000146094) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-08-24 |