| NPI | 1841553278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD453321) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 2017-00758) |
| 208600000X Surgery (Licence: PA MT201734) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-08-01 |