| NPI | 1538286620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D97963) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 22068) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2023-09-01 |