| NPI | 1629236229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD157529) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT189201) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2019-06-10 |