| NPI | 1053947093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD495924) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD495924) |
| 207X00000X Orthopaedic Surgery (Licence: TN 73338) | |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2026-07-05 |