| NPI | 1972500296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD154729) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SD 4173) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2019-08-14 |