| NPI | 1013446137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 291160) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 24570) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 291160) | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-11-08 |