| NPI | 1962895367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS019621) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H94086) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2023-11-06 |