| NPI | 1568435162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 044980) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC MD20481) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2019-10-29 |