| NPI | 1548580830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 10027) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-43591) |
| 207X00000X Orthopaedic Surgery (Licence: NE 29435) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2017-02-27 |