| NPI | 1083278055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 1018826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1018826) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2025-09-24 |