| NPI | 1194790386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 114133-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD057822L) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-02-19 |