| NPI | 1114451192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD481773) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD481773) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2024-08-20 |