| NPI | 1568842391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD-48124) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 7420) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2023-11-06 |