| NPI | 1003369323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NH 22367) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MD P32690) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2022-08-03 |