| NPI | 1033123807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD016274E) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: PA MD016274E) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: PA MD016274E) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2015-05-20 |