| NPI | 1699736793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD444405) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME90911) |
| 174400000X Specialist (Licence: PA MD444405) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-08-11 |