| NPI | 1700273356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 55415) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT209099) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.142179) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-02-05 |