| NPI | 1134509276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD476939) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301117223) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2022-06-09 |