| NPI | 1871859710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101269141) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD048249) |
| 207X00000X Orthopaedic Surgery (Licence: MD D85716) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2021-06-02 |