| NPI | 1871598110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0046821) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD21013) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101051792) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2013-11-07 |