| NPI | 1881754463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD430839) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: PA MD430839) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2015-09-04 |