| NPI | 1275784134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35123813) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD446230) |
| 207X00000X Orthopaedic Surgery (Licence: PA MT193000) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2021-06-17 |