| NPI | 1740331743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-13107) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD422606) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2015-00204) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-07-23 |