| NPI | 1316326648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD474816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11200400) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01083578A) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-02-22 |