| NPI | 1639258205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD433510) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL24193) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-05-13 |