| NPI | 1649595109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D89091) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26595) |
| Enumeration Date | 2010-03-28 |
| Last Update Date | 2020-06-24 |