| NPI | 1982880191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101249269) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD433214) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2015-09-15 |