| NPI | 1235127101 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD029924E) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA ME029924E) | 
| Enumeration Date | 2005-10-13 | 
| Last Update Date | 2017-03-21 |