| NPI | 1528385887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 54024) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD454940) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2016-07-18 |