| NPI | 1528087988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD445476) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-052114) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-03-08 |