| NPI | 1710078670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2007-0763) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 23800) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-06-12 |