| NPI | 1689820672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD d0074565) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D0074565) |
| 207X00000X Orthopaedic Surgery (Licence: DC MD040782) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2014-11-26 |