| NPI | 1770859654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD464460) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 10261484-1205) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2023-09-07 |