| NPI | 1396729265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD447695) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 24553) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 24553) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2026-06-16 |