| NPI | 1942648795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD463797) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT204271) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-10-26 |