| NPI | 1518967207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD425955) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD037178) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101243103) | |
| 207X00000X Orthopaedic Surgery (Licence: MD D0068746) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2020-10-24 |