| NPI | 1831247956 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D76502)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 018417)  | 
| 207X00000X Orthopaedic Surgery (Licence: DC MD041743)  | |
| Enumeration Date | 2007-01-08 | 
| Last Update Date | 2017-12-08 |