| NPI | 1922331784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 055466) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0082105) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2017-03-30 |