| NPI | 1649895178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD480285) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT221401) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2024-12-30 |