| NPI | 1447608336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD459313) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: ZZ IMC227017) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-09-30 |