| NPI | 1659480317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD448166) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA09389100) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR md20165) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME152747) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-02-22 |