| NPI | 1467770727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD459879) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP01852) |
| 207X00000X Orthopaedic Surgery (Licence: RI 14879) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2019-12-27 |