| NPI | 1861565137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D38564) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD16654) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101230560) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-06-07 |