| NPI | 1740204049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD19035) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD19035) |
| 207Q00000X Family Medicine (Licence: OR MD19035) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-11-10 |