| NPI | 1790031912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D89769) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.38287) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2023-03-28 |