| NPI | 1447426424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD440780) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT193729) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2013-11-20 |