| NPI | 1083650824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 227741) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A89707) |
| 207X00000X Orthopaedic Surgery (Licence: DC MD034828) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2024-08-29 |