| NPI | 1043496896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME120494) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD449299) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09316700) | |
| 207X00000X Orthopaedic Surgery (Licence: AR E-7130) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A115817) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2026-03-12 |