| NPI | 1447250477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD420667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 26756) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2025-04-02 |