| NPI | 1982605267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD151963) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 36264) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-09-17 |