| NPI | 1770514184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0010535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101020336) |
| 207X00000X Orthopaedic Surgery (Licence: DC MD5004) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-02-02 |