| NPI | 1629043005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD429053) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 20644) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35083055) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2026-04-28 |