| NPI | 1548232507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD036411L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 232143-1) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2007-07-08 |