| NPI | 1639171259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD25510) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD25510) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2023-04-06 |