| NPI | 1972531424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD041888L) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD041888L) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06546800) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME152883) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 298602) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-05-21 |