| NPI | 1962532465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101006401) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 006401) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2016-10-17 |