| NPI | 1750453916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2008-01829) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD-047705L) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2013-09-11 |