| NPI | 1790745560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD049880L) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD049880L) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2022-08-26 |