| NPI | 1821291238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD436148) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA mt182770) |
| 207X00000X Orthopaedic Surgery (Licence: MN 53435) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 104889) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-31 |