| NPI | 1568466951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD 037925 E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH LT4098) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-11-04 |