| NPI | 1972649531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D72309) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD P20257) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-04-10 |