| NPI | 1467895425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.136854) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10328800) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD464469) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2019-08-26 |