| NPI | 1023483369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC MD600003689) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101286203) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD20082) | |
| 207X00000X Orthopaedic Surgery (Licence: MD D0104232) | |
| Enumeration Date | 2015-12-12 |
| Last Update Date | 2025-11-03 |