| NPI | 1750321089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD194739) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 79616) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-03-24 |