| NPI | 1922008192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD012076) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM MD2012-0238) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2014-11-20 |