| NPI | 1518287010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD447323) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT196612) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2015-00478) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2017-10-16 |