| NPI | 1154397479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD424259) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD424259) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-02-02 |