| NPI | 1083720015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2007-01279) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101239734) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2007-01279) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 040906) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD D0059635) | |
| 208600000X Surgery (Licence: NC 2007-01279) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-08-26 |