| NPI | 1538108816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 327897-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD447324) |
| 207X00000X Orthopaedic Surgery (Licence: OH OH35062152) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-05-08 |