| NPI | 1497964142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.099160) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD442524) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08911300) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-06-07 |