| NPI | 1780995209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35.129227) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 57.018472) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD455701) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.129227) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2026-01-14 |