| NPI | 1821013145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD058456L) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA A41574) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MD058456L) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD058456L) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD058456L) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-09-18 |