| NPI | 1962486977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 23703) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD23703) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-07-15 |