| NPI | 1497080105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD451810) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD451810) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 390200000X) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2021-02-15 |