| NPI | 1548320310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 095118) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT181913) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD430648) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2010-11-01 |