| NPI | 1336587062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 298338) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT204697) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2021-03-31 |