| NPI | 1619903382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 6313441-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD431842) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2021-11-05 |