| NPI | 1417143520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35122271) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 46014) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD448709) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 46014) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2019-06-14 |