| NPI | 1992181895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D97977) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101263427) | 
| 207X00000X Orthopaedic Surgery (Licence: DC MD210012309) | |
| Enumeration Date | 2015-08-03 | 
| Last Update Date | 2024-06-05 |