| NPI | 1952935892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN NEJMAN Credentialing Specialist 814-868-2507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207QS0010X Family Medicine Sports Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine | |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2025-07-14 |