| NPI | 1700049103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D79199) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 71264) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2019-08-06 |