| NPI | 1417502063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD470126) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA LT000818) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2021-08-12 |