| NPI | 1366429474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD020597E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 9900468) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2016-12-23 |