| NPI | 1639491483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2019034593) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD446327) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2022-09-02 |