| NPI | 1053371047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD031197E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD 031197-E) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2008-05-08 |