| NPI | 1215998968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D96085) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD072798L) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD072798L) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-12-30 |