| NPI | 1548259773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD196515) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 3449-20) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2020-11-06 |