| NPI | 1679708713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.30641) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2014-00264) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2015-09-24 |