| NPI | 1013478403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD488887) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2024016481) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-09-11 |