| NPI | 1861011165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD494792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD600004200) |
| 207X00000X Orthopaedic Surgery (Licence: MD D0103731) | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2026-08-11 |