| NPI | 1770594418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101242055) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0021179) |
| 207X00000X Orthopaedic Surgery (Licence: DC MD13953) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-12-01 |