| NPI | 1538429824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 292102) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT201551) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-02-27 |