| NPI | 1013793736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX 47985) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX 47985) |
| 207X00000X Orthopaedic Surgery (Licence: NY 340221) | |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2025-10-17 |