| NPI | 1568424018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS009073L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H0058007) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-10-14 |