| NPI | 1356540249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 23302) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD426061) |
| 207X00000X Orthopaedic Surgery (Licence: CA A99117) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2022-04-12 |