| NPI | 1124015797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD018887E) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: PA MD018887E) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD018887E) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD018887E) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD018887E) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD018887E) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2013-09-18 |