| NPI | 1225355761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD471416) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26609) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-10-01 |