| NPI | 1770547069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: PA MD421588) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD421588) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: PA MD421588) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: PA MD421588) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-06-30 |