| NPI | 1891139572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2019009470) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD464204) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2019-08-20 |