| NPI | 1952927949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 344359) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT020333) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2026-07-22 |