| NPI | 1932996949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA MD487782) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD487782) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD487782) | |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-04-22 |