| NPI | 1235255167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35-094128) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD430230) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD430230) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD430230) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 249572-1) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2017-01-04 |