| NPI | 1306031893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD435905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD435905) |
| Enumeration Date | 2007-09-08 |
| Last Update Date | 2021-09-29 |