| NPI | 1093705469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MO 2016019905) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD066077L) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD066077L) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-03-07 |