| NPI | 1942596176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD-43595) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-07765) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-10-07 |