| NPI | 1063048916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD495254) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0103697) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2026-08-19 |