| NPI | 1023384997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D93996) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD464520) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2017-00196) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 2017-00196) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2023-02-28 |